Project Summary This Small Business Innovation Research Fast Track project aims to develop a wearable sensor system for hand hygiene compliance tracking and validate its efficacy through a pilot trial in clinical settings. Healthcare- Associated Infections (HAIs) are the most common type of complication for patients who are hospitalized. According to the Center for Disease Control and Prevention, in 2011 there were an estimated 721,800 HAIs in U.S. acute care hospitals that led to about 75,000 deaths and more than $20 billion in healthcare costs per year. The most effective strategy to improve hand-hygiene compliance includes monitoring hand-hygiene behaviors and, in turn, implementing performance-based interventions. Today, nearly all hospitals worldwide are still relying on direct observation to monitor healthcare providers? hand hygiene compliance, which is not only costly, labor-intensive, time consuming, inaccurate due to observer bias, but also inadequate since this technique only captures a small sample size of all hand hygiene opportunities. Therefore there is a vast market demand for electronic hand hygiene surveillance systems that can monitor providers? hand hygiene compliance automatically and continuously. In this research, we will 1) first develop a minimum viable product of the sensor system and assess its performance in lab settings; 2) conduct a 12-month crossover, randomized pilot study to test the performance of the sensor system in clinical settings and 3) develop a minimal marketable product for commercialization. We expect the proposed research to improve the hand hygiene practices and compliance rate of healthcare providers and ultimately reduce healthcare associated infection rate.